Yes, we still need chickenpox vaccines
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For people who grew up before a vaccine was available, chickenpox is largely remembered as an unpleasant experience that almost every child suffered through. The highly contagious disease tore through communities, leaving behind more than a few lasting scars.
For many children, chickenpox was much more than a week or two of itchy discomfort. It was a serious and sometimes life-threatening infection.
Prior to the chickenpox vaccine’s introduction in 1995, 90 percent of children got chickenpox. Those children grew into adults with an increased risk of developing shingles, a disease caused by the same virus—varicella-zoster—as chickenpox, which lies dormant in the body for decades.
The vaccine changed all that, nearly wiping out chickenpox in the U.S. in under three decades. The vaccine has been so successful that some people falsely believe the disease no longer exists and that vaccination is unnecessary. This couldn’t be further from the truth.
Vaccination spares children and adults from the misery of chickenpox and the serious short- and long-term risks associated with the disease. The CDC estimates that 93 percent of children in the U.S. are fully vaccinated against chickenpox. However, outbreaks can still occur among unvaccinated and under-vaccinated populations.
Here are some of the many reasons why we still need chickenpox vaccines.
Chickenpox is more serious than you may remember
For most children, chickenpox lasts around a week. Symptoms vary in severity but typically include a rash of small, itchy blisters that scab over, fever, fatigue, and headache.
However, in one out of every 4,000 chickenpox cases, the virus infects the brain, causing swelling. If the varicella-zoster virus makes it to the part of the brain that controls balance and muscle movements, it can cause a temporary loss of muscle control in the limbs that can last for months. Chickenpox can also cause other serious complications, including skin, lung, and blood infections.
Prior to the U.S.’ approval of the vaccine in 1995, children accounted for most of the country’s chickenpox cases, with over 10,000 U.S. children hospitalized with chickenpox each year.
The chickenpox vaccine is very effective and safe
Chickenpox is an extremely contagious disease. People without immunity have a 90 percent chance of contracting the virus if exposed.
Fortunately, the chickenpox vaccine provides lifetime protection and is around 90 percent effective against infection and nearly 100 percent effective against severe illness. It also reduces the risk of developing shingles later in life.
In addition to being incredibly effective, the chickenpox vaccine is very safe, and serious side effects are extremely rare. Some people may experience mild side effects after vaccination, such as pain at the injection site and a low fever.
Although infection provides immunity against future chickenpox infections, letting children catch chickenpox to build up immunity is never worth the risk, especially when a safe vaccine is available. The purpose of vaccination is to gain immunity without serious risk.
The chickenpox vaccine is one of the greatest vaccine success stories in history
It’s difficult to overstate the impact of the chickenpox vaccine. Within five years of the U.S. beginning universal vaccination against chickenpox, the disease had declined by over 80 percent in some regions.
Nearly 30 years after the introduction of the chickenpox vaccine, the disease is almost completely wiped out. Cases and hospitalizations have plummeted by 97 percent, and chickenpox deaths among people under 20 are essentially nonexistent.
Thanks to the vaccine, in less than a generation, a disease that once swept through schools and affected nearly every child has been nearly eliminated. And, unlike vaccines introduced in the early 20th century, no one can argue that improved hygiene, sanitation, and health helped reduce chickenpox cases beginning in the 1990s.
Having chickenpox as a child puts you at risk of shingles later
Although most people recover from chickenpox within a week or two, the virus that causes the disease, varicella-zoster, remains dormant in the body. This latent virus can reactivate years after the original infection as shingles, a tingling or burning rash that can cause severe pain and nerve damage.
One in 10 people who have chickenpox will develop shingles later in life. The risk increases as people get older as well as for those with weakened immune systems.
Getting chickenpox as an adult can be deadly
Although chickenpox is generally considered a childhood disease, it can affect unvaccinated people of any age. In fact, adult chickenpox is far deadlier than pediatric cases.
Serious complications like pneumonia and brain swelling are more common in adults than in children with chickenpox. One in 400 adults who get chickenpox develops pneumonia, and one to two out of 1,000 develop brain swelling.
Vaccines have virtually eliminated chickenpox, but outbreaks still happen
Although the chickenpox vaccine has dramatically reduced the impact of a once widespread disease, declining immunity could lead to future outbreaks. A Centers for Disease Control and Prevention analysis found that chickenpox vaccination rates dropped in half of U.S. states in the 2022-2023 school year compared to the previous year. And more than a dozen states have immunization rates below 90 percent.
In 2024, New York City and Florida had chickenpox outbreaks that primarily affected unvaccinated and under-vaccinated children. With declining public confidence in routine vaccines and rising school vaccine exemption rates, these types of outbreaks will likely become more common.
The CDC recommends that children receive two chickenpox vaccine doses before age 6. Older children and adults who are unvaccinated and have never had chickenpox should also receive two doses of the vaccine.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Why Going Gluten-Free Could Be A Bad Idea
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Is A Gluten-Free Diet Right For You?
This is Rachel Begun, MS, RD. She’s a nutritionist who, since her own diagnosis with Celiac disease, has shifted her career into a position of educating the public (and correcting misconceptions) about gluten sensitivity, wheat allergy, and Celiac disease. In short, the whole “gluten-free” field.
First, a quick recap
We’ve written on this topic ourselves before; here’s what we had to say:
On “Everyone should go gluten-free”
Some people who have gone gluten-free are very evangelical about the lifestyle change, and will advise everyone that it will make them lose weight, have clearer skin, more energy, and sing well, too. Ok, maybe not the last one, but you get the idea—a dietary change gets seen as a cure-all.
And for some people, it can indeed make a huge difference!
Begun urges us to have a dose of level-headedness in our approach, though.
Specifically, she advises:
- Don’t ignore symptoms, and/but…
- Don’t self-diagnose
- Don’t just quit gluten
One problem with self-diagnosis is that we can easily be wrong:
But why is that a problem? Surely there’s not a health risk in skipping the gluten just to be on the safe side? As it turns out, there actually is:
If we self-diagnose incorrectly, Begun points out, we can miss the actual cause of the symptoms, and by cheerfully proclaiming “I’m allergic to gluten” or such, a case of endometriosis, or Hashimoto’s, or something else entirely, might go undiagnosed and thus untreated.
“Oh, I feel terrible today, there must have been some cross-contamination in my food” when in fact, it’s an undiagnosed lupus flare-up, that kind of thing.
Similarly, just quitting gluten “to be on the safe side” can mask a different problem, if wheat consumption (for example) contributed to, but did not cause, some ailment.
In other words: it could reduce your undesired symptoms, but in so doing, leave a more serious problem unknown.
Instead…
If you suspect you might have a gluten sensitivity, a wheat allergy, or even Celiac disease, get yourself tested, and take professional advice on proceeding from there.
How? Your physician should be able to order the tests for you.
You can also check out resources available here:
Celiac Disease Foundation | How do I get tested?
Or for at-home gluten intolerance tests, here are some options weighed against each other:
MNT | 5 gluten intolerance tests and considerations
Want to learn more?
Begun has a blog:
Rachel Begun | More than just recipes
(it is, in fact, just recipes—but they are very simple ones!)
You also might enjoy this interview, in which she talks about gluten sensitivity, celiac disease, and bio-individuality:
Want to watch it, but not right now? Bookmark it for later
Take care!
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Zero Sugar / One Month – by Becky Gillaspy
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We’ve reviewed books about the evils of sugar before, so what makes this one different?
This one has a focus on helping the reader quit it. It assumes we already know the evils of sugar (though it does cover that too).
It looks at the mechanisms of sugar addiction (habits-based and physiological), and how to safely and painlessly cut through those to come out the other side, free from sugar.
The author gives a day-by-day plan, for not only eliminating sugar, but also adding and including things to fill the gap it leaves, keeping us sated, energized, and happy along the way.
In the category of subjective criticism, it does also assume we want to lose weight, which may not be the case for many readers. But that’s a by-the-by and doesn’t detract from the useful guide to quitting sugar, whatever one’s reasons.
Bottom line: if you would like to quit sugar but find it hard, this book thinks of everything and walks you by the hand, making it easy.
Click here to check out Zero Sugar / One Month, and reap the health benefits!
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One in twenty people has no sense of smell – here’s how they might get it back
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During the pandemic, a lost sense of smell was quickly identified as one of the key symptoms of COVID. Nearly four years later, one in five people in the UK is living with a decreased or distorted sense of smell, and one in twenty have anosmia – the total loss of the ability to perceive any odours at all. Smell training is one of the few treatment options for recovering a lost sense of smell – but can we make it more effective?
Smell training is a therapy that is recommended by experts for recovering a lost sense of smell. It is a simple process that involves sniffing a set of different odours – usually essential oils, or herbs and spices – every day.
The olfactory system has a unique ability to regenerate sensory neurons (nerve cells). So, just like physiotherapy where exercise helps to restore movement and function following an injury, repeated exposure to odours helps to recover the sense of smell following an infection, or other cause of smell loss (for example, traumatic head injury).
Several studies have demonstrated the effectiveness of smell training under laboratory conditions. But recent findings have suggested that the real-world results might be disappointing.
One reason for this is that smell training is a long-term therapy. It can take months before patients detect anything, and some people may not get any benefit at all.
In one study, researchers found that after three months of smell training, participation dropped to 88%, and further declined to 56% after six months. The reason given was that these people did not feel as though they noticed any improvement in their ability to smell.
Cross-modal associations
To remedy this, researchers are now investigating how smell training can be improved. One interesting idea is that information from our other senses, or “cross-modal associations”, can be applied to smell training to promote odour perception and improve the results.
Cross-modal associations are described as the tendency for sensory cues from different sensory systems to be matched. For example, brightness tends to be associated with loudness. Pitch is related to size. Colours are linked to temperature, and softness is matched with round shapes, while spiky shapes feel more rough. In previous studies, these associations have been shown to have a considerable influence on how sensory information is processed. Especially when it comes to olfaction.
Recent research has shown that the sense of smell is influenced by a combination of different sensory inputs – not just odours. Sensory cues such as colour, shape, and pitch are believed to play a role in the ability to correctly identify and name odours, and can influence perceptions of odour pleasantness and intensity.
In one study, participants were asked to complete a test that measured their ability to discriminate between different odours while they were presented with the colour red or yellow, an outline drawing of a strawberry or a lemon, or a combination of these colours and shapes. The results suggested that corresponding odour and colour associations (for example, the colour red and strawberry) were linked to increased olfactory performance compared with odours and colours that were not associated (for example, the colour yellow and strawberry).
People who associated strawberries with the colour red performed better on smell tests. GCapture/Shutterstock While projects focusing on harnessing these cross-modal associations to improve treatments for smell loss are underway, research has already started to deliver some promising results.
In a recent study that aimed to investigate whether the effects of smell training could be improved with the addition of cross-modal associations, participants watched a guidance video containing sounds that matched the odours that they were training with. The results suggest that cross-modal interactions plus smell training improved olfactory function compared to smell training alone.
The results reported in recent studies have been promising and offer new insights into the field of olfactory science. It is hoped that this will soon lead to the development of more effective treatment options for smell recovery.
In the meantime, smell training is one of the best things you can do for a lost sense of smell, so patients are encouraged to stick with it so that they give themselves the best chance at recovery.
Emily Spencer, PhD Candidate, Olfaction, Edinburgh Napier University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Can a drug like Ozempic help treat addictions to alcohol, opioids or other substances?
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Semaglutide (sold as Ozempic, Wegovy and Rybelsus) was initially developed to treat diabetes. It works by stimulating the production of insulin to keep blood sugar levels in check.
This type of drug is increasingly being prescribed for weight loss, despite the fact it was initially approved for another purpose. Recently, there has been growing interest in another possible use: to treat addiction.
Anecdotal reports from patients taking semaglutide for weight loss suggest it reduces their appetite and craving for food, but surprisingly, it also may reduce their desire to drink alcohol, smoke cigarettes or take other drugs.
But does the research evidence back this up?
Animal studies show positive results
Semaglutide works on glucagon-like peptide-1 receptors and is known as a “GLP-1 agonist”.
Animal studies in rodents and monkeys have been overwhelmingly positive. Studies suggest GLP-1 agonists can reduce drug consumption and the rewarding value of drugs, including alcohol, nicotine, cocaine and opioids.
Out team has reviewed the evidence and found more than 30 different pre-clinical studies have been conducted. The majority show positive results in reducing drug and alcohol consumption or cravings. More than half of these studies focus specifically on alcohol use.
However, translating research evidence from animal models to people living with addiction is challenging. Although these results are promising, it’s still too early to tell if it will be safe and effective in humans with alcohol use disorder, nicotine addiction or another drug dependence.
What about research in humans?
Research findings are mixed in human studies.
Only one large randomised controlled trial has been conducted so far on alcohol. This study of 127 people found no difference between exenatide (a GLP-1 agonist) and placebo (a sham treatment) in reducing alcohol use or heavy drinking over 26 weeks.
In fact, everyone in the study reduced their drinking, both people on active medication and in the placebo group.
However, the authors conducted further analyses to examine changes in drinking in relation to weight. They found there was a reduction in drinking for people who had both alcohol use problems and obesity.
For people who started at a normal weight (BMI less than 30), despite initial reductions in drinking, they observed a rebound increase in levels of heavy drinking after four weeks of medication, with an overall increase in heavy drinking days relative to those who took the placebo.
There were no differences between groups for other measures of drinking, such as cravings.
Some studies show a rebound increase in levels of heavy drinking. Deman/Shutterstock In another 12-week trial, researchers found the GLP-1 agonist dulaglutide did not help to reduce smoking.
However, people receiving GLP-1 agonist dulaglutide drank 29% less alcohol than those on the placebo. Over 90% of people in this study also had obesity.
Smaller studies have looked at GLP-1 agonists short-term for cocaine and opioids, with mixed results.
There are currently many other clinical studies of GLP-1 agonists and alcohol and other addictive disorders underway.
While we await findings from bigger studies, it’s difficult to interpret the conflicting results. These differences in treatment response may come from individual differences that affect addiction, including physical and mental health problems.
Larger studies in broader populations of people will tell us more about whether GLP-1 agonists will work for addiction, and if so, for whom.
How might these drugs work for addiction?
The exact way GLP-1 agonists act are not yet well understood, however in addition to reducing consumption (of food or drugs), they also may reduce cravings.
Animal studies show GLP-1 agonists reduce craving for cocaine and opioids.
This may involve a key are of the brain reward circuit, the ventral striatum, with experimenters showing if they directly administer GLP-1 agonists into this region, rats show reduced “craving” for oxycodone or cocaine, possibly through reducing drug-induced dopamine release.
Using human brain imaging, experimenters can elicit craving by showing images (cues) associated with alcohol. The GLP-1 agonist exenatide reduced brain activity in response to an alcohol cue. Researchers saw reduced brain activity in the ventral striatum and septal areas of the brain, which connect to regions that regulate emotion, like the amygdala.
In studies in humans, it remains unclear whether GLP-1 agonists act directly to reduce cravings for alcohol or other drugs. This needs to be directly assessed in future research, alongside any reductions in use.
Are these drugs safe to use for addiction?
Overall, GLP-1 agonists have been shown to be relatively safe in healthy adults, and in people with diabetes or obesity. However side effects do include nausea, digestive troubles and headaches.
And while some people are OK with losing weight as a side effect, others aren’t. If someone is already underweight, for example, this drug might not be suitable for them.
In addition, very few studies have been conducted in people with addictive disorders. Yet some side effects may be more of an issue in people with addiction. Recent research, for instance, points to a rare risk of pancreatitis associated with GLP-1 agonists, and people with alcohol use problems already have a higher risk of this disorder.
Other drugs treatments are currently available
Although emerging research on GLP-1 agonists for addiction is an exciting development, much more research needs to be done to know the risks and benefits of these GLP-1 agonists for people living with addiction.
In the meantime, existing effective medications for addiction remain under-prescribed. Only about 3% of Australians with alcohol dependence, for example, are prescribed medication treatments such as like naltrexone, acamprosate or disulfiram. We need to ensure current medication treatments are accessible and health providers know how to prescribe them.
Continued innovation in addiction treatment is also essential. Our team is leading research towards other individualised and effective medications for alcohol dependence, while others are investigating treatments for nicotine addiction and other drug dependence.
Read the other articles in The Conversation’s Ozempic series here.
Shalini Arunogiri, Addiction Psychiatrist, Associate Professor, Monash University; Leigh Walker, , Florey Institute of Neuroscience and Mental Health, and Roberta Anversa, , The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Navigating the health-care system is not easy, but you’re not alone.
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Hello, dear reader!
This is my first column for Healthy Debate as a Patient Navigator. This column will be devoted to providing patients with information to help them through their journey with the health-care system and answering your questions.
Here’s a bit about me: I have been a patient partner at The Ottawa Hospital and Ottawa Hospital Research Institute since 2017, and have joined a variety of governance boards that work on patient and caregiver engagement such as the Patient Advisors Network, the Ontario Health East Region Patient and Family Advisory Council and the Equity in Health Systems Lab.
My journey as a patient partner started much before 2017 though. When I was a teenager, I was diagnosed with a cholesteatoma, a rare and chronic disease that causes the development of fatty tumors in the middle ear. I have had multiple surgeries to try to fix it but will need regular follow-ups to monitor whether the tumor returns. Because of this, I also live with an invisible disability since I have essentially become functionally deaf in one ear and often rely on a hearing aid when I navigate the world.
Having undergone three surgeries in my adolescent years, it was my experience undergoing surgery for an acute hand and wrist injury following a jet ski accident as an adult that was the catalyst for my decision to become a patient partner. There was an intriguing contrast between how I was cared for at two different health-care institutions, my age being the deciding factor at which hospital I went to (a children’s hospital or an adult one).
The most memorable example was how, as a teenager or child, you were never left alone before surgery, and nurses and staff took all the time necessary to comfort me and answer my (and my family’s) questions. I also remember how right before putting me to sleep, the whole staff initiated a surgical pause and introduced themselves and explained to me what their role was during my surgery.
None of that happened as an adult. I was left in a hallway while the operating theater was prepared, anxious and alone with staff walking by not even batting an eye. My questions felt like an annoyance to the care team; as soon as I was wheeled onto the operating room table, the anesthetist quickly put me to sleep. I didn’t even have the time to see who else was there.
Now don’t get me wrong: I am incredibly appreciative with the quality of care I received, but it was the everyday interactions with the care teams that I felt could be improved. And so, while I was recovering from that surgery, I looked for a way to help other patients and the hospital improve its care. I discovered the hospital’s patient engagement program, applied, and the rest is history!
Since then, I have worked on a host of patient-centered policy and research projects and fervently advocate that surgical teams adopt a more compassionate approach with patients before and after surgery.
I’d be happy to talk a bit more about my journey if you ask, but with that out of the way … Welcome to our first patient navigator column about patient engagement.
Conceptualizing the continuum of Patient Engagement
In the context of Canadian health care, patient engagement is a multifaceted concept that involves active collaboration between patients, caregivers, health-care providers and researchers. It involves patients and caregivers as active contributors in decision-making processes, health-care services and medical research. Though the concept is not new, the paradigm shift toward patient engagement in Canada started around 2010.
I like to conceptualize the different levels of patient engagement as a measure of the strength of the relationship between patients and their interlocutors – whether it’s a healthcare provider, administrator or researcher – charted against the duration of the engagement or the scope of input required from the patient.
Defining different levels of Patient Engagement
Following the continuum, let’s begin by defining different levels of patient engagement. Bear in mind that these definitions can vary from one organization to another but are useful in generally labelling the level of patient engagement a project has achieved (or wishes to achieve).
Patient involvement: If the strength of the relationship between patients and their interlocutors is minimal and not time consuming or too onerous, then perhaps it can be categorized as patient involvement. This applies to many instances of transactional engagement.
Patient advisory/consulting: Right in the middle of our continuum, patients can find themselves engaging in patient advisory or consulting work, where projects are limited in scope and duration or complexity, and the relationship is not as profound as a partnership.
Patient partnership: The stronger the relationship is between the patient and their interlocutor, and the longer the engagement activity lasts or how much input the patient is providing, the more this situation can be categorized as patient partnership. It is the inverse of patient involvement.
Examples of the different levels of Patient Engagement
Let’s pretend you are accompanying a loved one to an appointment to manage a kidney disease, requiring them to undergo dialysis treatment. We’ll use this scenario to exemplify what label could be used to describe the level of engagement.
Patient involvement: In our case, if your loved one – or you – fills out a satisfaction or feedback survey about your experience in the waiting room and all that needed to be done was to hand it back to the clerk or care team, then, at a basic level, you could likely label this interaction as a form of patient involvement. It can also involve open consultations around a design of a new look and feel for a hospital, or the understandability of a survey or communications product. Interactions with the care team, administrators or researchers are minimal and often transactional.
Patient advisory/consulting: If your loved one was asked for more detailed information about survey results over the course of a few meetings, this could represent patient advisory/consulting. This could mean that patients meet with program administrators and care providers and share their insights on how things can be improved. It essentially involves patients providing advice to health-care institutions from the perspective of patients, their family members and caregivers.
Patient advisors or consultants are often appointed by hospitals or academic institutions to offer insights at multiple stages of health-care delivery and research. They can help pilot an initiative based on that feedback or evaluate whether the new solutions are working. Often patient advisors are engaged in smaller-term individual projects and meet with the project team as regularly as required.
Patient partnership: Going above and beyond patient advisory, if patients have built a trusting relationship with their care team or administrators, they could feel comfortable enough to partner with them and initiate a project of their own. This could be for a project in which they study a different form of treatment to improve patient-centered outcomes (like the time it takes to feel “normal” following a session); it could be working together to identify and remove barriers for other patients that need to access that type of care. These projects are not fulfilled overnight, but require a collaborative, longstanding and trusting relationship between patients and health-care providers, administrators or researchers. It ensures that patients, regardless of severity or chronicity of their illness, can meaningfully contribute their experiences to aid in improving patient care, or develop or implement policies, pilots or research projects from start to finish.
It is leveraging that lived and living experience to its full extent and having the patient partner involved as an equal voice in the decision-making process for a project – over many months, usually – that the engagement could be labeled a partnership.
Last words
The point of this column will be to answer or explore issues or questions related to patient engagement, health communications or even provide some thoughts on how to handle a particular situation.
I would be happy to collect your questions and feedback at any time, which will help inform future columns. Just email me at max@le-co.ca or connect with me on social media (Linked In, X / Twitter).
It’s not easy to navigate our health-care systems, but you are not alone.
This article is republished from healthydebate under a Creative Commons license. Read the original article.
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Beyond Balancing The Books – by George Marino, CPA, CFP
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We hear a lot about the importance of mindfulness, yet how can Zen-like non-attachment to the material world go well with actually surviving (let alone thriving) in a Capitalist society?
Books that try to connect the two often end up botching it badly to the level of early 2000s motivational posters.
So, what does this book do differently? Mostly it’s because rather than a motivational speech with exhortations to operate on a higher plain and manifest your destiny and all that, it gives practical, down-to-earth advice and offers small simple things you can do or change to mindfully engage with the world of business rather than operating on auto-pilot.
Basically: how to cut out the stress without cutting out your performance.
All in all, we think both your health and your productivity will thank you for it!
Take Your Business (and Brain) “Beyond Balancing The Books” Today
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